One-year mortality after hospital admission as an indicator of palliative care need: A retrospective cohort study.
One-year mortality after hospital admission as an indicator of palliative care need: A retrospective cohort study.
复制标题
入院后一年死亡率作为姑息治疗需求的指标：一项回顾性队列研究。
DOI：
10.7196/samj.2021.v111i11.15869
复制
发表时间：
2021
期刊：
影响因子：
--
通讯作者：
P. Raubenheimer
中科院分区：
文献类型：
--
作者：
P. Frankenfeld;L. van Niekerk;K. Manning;N. Tiffin;P. Raubenheimer
背景
在全球范围内，人们越来越意识到，在生命的最后一年，住院患者需要临终关怀和姑息治疗。关于中低收入国家姑息治疗需求的数据有限，阻碍了为这些患者设计和实施有效的政策和保健服务。
目标
确定南非（SA）公立医院入院后1年内死亡的患者比例，作为SA姑息治疗需求的代表。
方法
这是一项回顾性队列研究，使用入院和死亡数据的记录联系。研究背景为南非西开普省的46家急性护理公立医院。
结果
2012年3月，在46家医院2周内收治的10761例患者（中位（四分位距（IQR））年龄44（31 - 60）岁）中，1570例（14.6%）在1年内死亡，大多数在前3个月内死亡。死亡率随着年龄的增长而急剧上升。中位（IQR）死亡年龄为57.5（45 - 70）岁。内科住院患者在1年内死亡的比例（21.3%）高于外科住院患者（7.7%）。
结论
尽管入院时的中位年龄<60岁，但在南澳大利亚州公立医院住院的患者中，有很大一部分处于生命的最后一年。这一发现应被视为在SA的高传染性和非传染性疾病负担和资源有限的公共卫生系统的背景下，并强调了政策的制定，规划和实施的需要临终关怀和姑息治疗战略的医院和病人。
BACKGROUND
Globally there is increasing awareness of the need for end-of-life care and palliative care in hospitalised patients who are in their final year of life. Limited data are available on palliative care requirements in low- and middle-income countries, hindering the design and implementation of effective policies and health services for these patients.
OBJECTIVES
To determine the proportion of patients who die within 1 year of their date of admission to public hospitals in South Africa (SA), as a proxy for palliative care need in SA.
METHODS
This was a retrospective cohort study using record linkage of admission and mortality data. The setting was 46 acute-care public hospitals in Western Cape Province, SA.
RESULTS
Of 10 761 patients (median (interquartile range (IQR)) age 44 (31 - 60) years) admitted to the 46 hospitals over a 2-week period in March 2012, 1 570 (14.6%) died within 1 year, the majority within the first 3 months. Mortality rose steeply with age. The median (IQR) age of death was 57.5 (45 - 70) years. A greater proportion of patients admitted to medical beds died within 1 year (21.3%) compared with those admitted to surgical beds (7.7%).
CONCLUSIONS
Despite a median age <60 years at admission, a substantial percentage of patients admitted to public sector hospitals in SA are in the final year of their lives. This finding should be seen in the context of SA's high communicable and non-communicable disease burden and resource-limited public health system, and highlights the need for policy development, planning and implementation of end-of-life and palliative care strategies for hospitals and patients.